PITTSBURGH TRIBUNE_REVIEW - An international study led by scientists at the University of Pittsburgh and UPMC found that inexpensive steroids improve outcomes of severely ill COVID-19 patients. The World Health Organization has updated treatment guidance in reaction to the study.
The findings were published Wednesday in the Journal of the American Medical Association as part of a four-article package. The Pitt and UPMC trial is one of seven randomized clinical trials evaluating three steroids in more than 1,700 patients. An analysis of the data pooled concludes each of the corticosteroids studied reduces mortality. When it comes to patients who must be ventilated, the steroids can relieve inflammation around the lungs, the site of the COVID-19 infection.
UPMC’s trial was the only U.S.-based trial to test corticosteroids treatment for critically ill patients, according to a news release. Analysis from the data collected, combined with the six other trials, reinforces the results of a June trial conducted in the United Kingdom. That trial found the steroid dexamethasone reduced COVID-19 deaths by 29%.
“It is relatively rare in medicine that you find drugs where the evidence of their effectiveness in saving lives is so consistent,” said lead author Dr. Derek Angus (BCHS ’92), chief health care innovation officer at UPMC, chair of the Department of Critical Care Medicine, and Distinguished Professor of health policy and management at Pitt. “This is, in many respects, the single clearest answer we’ve had so far on how to manage terribly ill COVID-19 patients. People on ventilators or oxygen and under intensive care should definitely be given corticosteroids.”
UPMC’s trial did not test the corticosteroids in nonhospitalized COVID-19 patients who didn’t need respiratory support. Steroids aren’t recommended for these patients because they can dampen the immune system and have serious side effects.
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NY TIMES - International clinical trials published on Wednesday confirm the hope that cheap, widely available steroid drugs can help seriously ill patients survive Covid-19, the illness caused by the coronavirus. Based on the new evidence, the World Health Organization issued new treatment guidance, strongly recommending steroids to treat severely and critically ill patients, but not to those with mild disease.
The studies “are like the second punch of a one-two punch,” said Dr. Derek C. Angus (BCHS ’92), chair of the department of critical care medicine at the University of Pittsburgh, who co-authored one of the new studies and the analysis. “I had a big smile on my face when I saw the results,” Dr. Angus added. “This is a case of, ‘A question asked, a question answered,’ and that’s so rare.”
NPR – Pitt Medical Center’s Derek Angus (BCHS ’92) said that while some worried that steroids could also prevent the body from fighting off the coronavirus, all the coordinated studies reached the same conclusion, which is, I guess we have to stop our trials. It is reassuring that we can get randomized trials executed successfully and rapidly in the face of a pandemic, and it definitely puts us on a sure footing.
9/02/2020